NAS2 Challenge Exam 2026/2027 | Actual Questions
Standard University College of Nursing | Actual Q&A | BSN and RN-to-BSN Students
Introduction
This original NAS2 Challenge Exam practice set covers advanced Head/Neck/Neurological Assessment,
Cardiovascular/Respiratory/Peripheral Vascular Assessment, Abdominal/Gastrointestinal/Genitourinary
Assessment, and Musculoskeletal/Dermatological/Endocrine Assessment. The questions emphasize comprehensive
physical examination techniques, differentiation of normal and abnormal findings, diagnostic reasoning, and
evidence-based assessment strategies. This document is designed to reinforce NAS2 Nursing Assessment and Skills
II course objectives and support exam readiness for pre-licensure BSN students, RN-to-BSN students, and nursing
challenge exam candidates.
Content Area Overview
Content Area Questions Key Topics Weight
Cranial nerve assessment,
Advanced Health
mental status evaluation,
Assessment of Head,
25 thyroid and lymph node 25%
Neck, and Neurological
palpation, sensory
Systems
function testing
Advanced Health
Heart sounds and
Assessment of
murmurs, lung field
Cardiovascular,
25 auscultation, peripheral 25%
Respiratory, and
pulse evaluation, edema
Peripheral Vascular
assessment
Systems
Abdominal quadrant
Advanced Health
auscultation and
Assessment of Abdominal,
25 palpation, liver and spleen 25%
Gastrointestinal, and
percussion, renal CVA
Genitourinary Systems
tenderness assessment
Advanced Health Joint range of motion,
Assessment of muscle strength grading,
Musculoskeletal, 25 skin lesion 25%
Dermatological, and characterization, thyroid
Endocrine Systems gland inspection
Complete NAS2
Total 100 advanced health 100%
assessment coverage
Actual Questions
Domain: Advanced Health Assessment of Head, Neck, and Neurological Systems
1. A nurse begins an advanced neurological assessment by asking the patient to state their name,
location, date, and reason for the visit. Which component is being assessed?
A. Level of consciousness only
B. Orientation within mental status
C. Cerebellar coordination
D. Sensory discrimination
Answer: B
Rationale: Orientation to person, place, time, and situation is a core mental status finding and helps establish a
baseline for neurological reasoning.
2. Which three response categories are scored in the Glasgow Coma Scale?
A. Eye opening, verbal response, and motor response
B. Pupillary size, gait, and reflexes
NAS2 Challenge Exam 2026/2027
,C. Cranial nerve function, strength, and sensation
D. Memory, judgment, and affect
Answer: A
Rationale: The Glasgow Coma Scale quantifies eye, verbal, and motor responses. It is used to trend level of
consciousness after injury or neurological decline.
3. Which technique is most appropriate for screening cranial nerve II visual acuity in a clinic
setting?
A. Asking the patient to shrug against resistance
B. Using a Snellen or near-vision chart
C. Testing gag reflex with a tongue blade
D. Palpating the temporal artery
Answer: B
Rationale: Cranial nerve II carries visual sensory input. Snellen or near-vision testing is a standard method for
assessing visual acuity.
4. When a light is directed into the right eye, both pupils constrict. Which cranial nerve provides
the efferent limb for pupillary constriction?
A. Optic nerve, CN II
B. Trochlear nerve, CN IV
C. Oculomotor nerve, CN III
D. Trigeminal nerve, CN V
Answer: C
Rationale: The oculomotor nerve carries parasympathetic fibers responsible for pupillary constriction. CN II is
the afferent limb for light perception.
5. A patient is asked to follow the nurse's finger through six cardinal fields of gaze. What is the
nurse primarily assessing?
A. Extraocular muscle function mediated by CN III, IV, and VI
B. Facial sensation mediated by CN V
C. Hearing acuity mediated by CN VIII
D. Tongue strength mediated by CN XII
Answer: A
Rationale: The six cardinal fields assess coordinated eye movement involving the oculomotor, trochlear, and
abducens nerves.
6. Which finding specifically evaluates the motor branch of the trigeminal nerve?
A. Patient clenches teeth while the nurse palpates the masseter muscles
B. Patient identifies a familiar smell with each nostril
C. Patient reads small print from a card
D. Patient repeats whispered numbers
Answer: A
Rationale: CN V motor function innervates muscles of mastication. Palpating the masseter and temporal muscles
during clenching screens this function.
7. Which instruction best screens motor function of the facial nerve?
A. Smile, frown, raise eyebrows, and puff out cheeks
B. Turn the head against resistance
C. Swallow water while the thyroid is palpated
D. Identify vibration on the great toe
Answer: A
Rationale: CN VII controls muscles of facial expression. Symmetry during smiling, frowning, eyebrow elevation,
and cheek puffing is assessed.
8. Which bedside test compares air conduction to bone conduction?
A. Romberg test
B. Rinne test
C. Weber test
D. Brudzinski test
NAS2 Challenge Exam 2026/2027
, Answer: B
Rationale: The Rinne test compares air and bone conduction using a tuning fork. It helps screen conductive
versus sensorineural patterns.
9. A nurse asks the patient to say “ah” while observing symmetric palate elevation. Which cranial
nerves are primarily assessed?
A. CN I and II
B. CN III and IV
C. CN IX and X
D. CN XI and XII
Answer: C
Rationale: Glossopharyngeal and vagus nerves contribute to palate elevation, swallowing, and phonation.
Asymmetric movement may indicate neurological dysfunction.
10. Which action tests the spinal accessory nerve?
A. Shoulder shrug against resistance
B. Tongue protrusion at midline
C. Corneal light reflex
D. Identification of sharp versus dull touch
Answer: A
Rationale: CN XI innervates the trapezius and sternocleidomastoid muscles. Shoulder shrug and head turn
against resistance screen its motor function.
11. The nurse asks the patient to protrude the tongue and move it side to side. Which nerve is being
assessed?
A. Facial nerve, CN VII
B. Hypoglossal nerve, CN XII
C. Vestibulocochlear nerve, CN VIII
D. Accessory nerve, CN XI
Answer: B
Rationale: CN XII controls tongue movement. Deviation, weakness, or fasciculations can suggest hypoglossal
impairment.
12. A patient repeatedly overshoots the nurse's finger during finger-to-nose testing. Which
abnormal finding is present?
A. Dysmetria
B. Aphasia
C. Nuchal rigidity
D. Anosmia
Answer: A
Rationale: Dysmetria is impaired judgment of distance or range of movement. It is commonly associated with
cerebellar dysfunction.
13. Which abnormality is demonstrated by inability to perform rapid alternating hand movements
smoothly?
A. Dysdiadochokinesia
B. Miosis
C. Presbyopia
D. Exophthalmos
Answer: A
Rationale: Dysdiadochokinesia is impaired rapid alternating movement and suggests cerebellar involvement.
14. A patient can stand steadily with eyes open but sways markedly when the eyes are closed. What
does this positive Romberg test suggest?
A. Impaired proprioception or vestibular function
B. Normal cerebellar function without concern
C. Acute thyroid enlargement
D. Conductive hearing loss only
Answer: A
NAS2 Challenge Exam 2026/2027
Standard University College of Nursing | Actual Q&A | BSN and RN-to-BSN Students
Introduction
This original NAS2 Challenge Exam practice set covers advanced Head/Neck/Neurological Assessment,
Cardiovascular/Respiratory/Peripheral Vascular Assessment, Abdominal/Gastrointestinal/Genitourinary
Assessment, and Musculoskeletal/Dermatological/Endocrine Assessment. The questions emphasize comprehensive
physical examination techniques, differentiation of normal and abnormal findings, diagnostic reasoning, and
evidence-based assessment strategies. This document is designed to reinforce NAS2 Nursing Assessment and Skills
II course objectives and support exam readiness for pre-licensure BSN students, RN-to-BSN students, and nursing
challenge exam candidates.
Content Area Overview
Content Area Questions Key Topics Weight
Cranial nerve assessment,
Advanced Health
mental status evaluation,
Assessment of Head,
25 thyroid and lymph node 25%
Neck, and Neurological
palpation, sensory
Systems
function testing
Advanced Health
Heart sounds and
Assessment of
murmurs, lung field
Cardiovascular,
25 auscultation, peripheral 25%
Respiratory, and
pulse evaluation, edema
Peripheral Vascular
assessment
Systems
Abdominal quadrant
Advanced Health
auscultation and
Assessment of Abdominal,
25 palpation, liver and spleen 25%
Gastrointestinal, and
percussion, renal CVA
Genitourinary Systems
tenderness assessment
Advanced Health Joint range of motion,
Assessment of muscle strength grading,
Musculoskeletal, 25 skin lesion 25%
Dermatological, and characterization, thyroid
Endocrine Systems gland inspection
Complete NAS2
Total 100 advanced health 100%
assessment coverage
Actual Questions
Domain: Advanced Health Assessment of Head, Neck, and Neurological Systems
1. A nurse begins an advanced neurological assessment by asking the patient to state their name,
location, date, and reason for the visit. Which component is being assessed?
A. Level of consciousness only
B. Orientation within mental status
C. Cerebellar coordination
D. Sensory discrimination
Answer: B
Rationale: Orientation to person, place, time, and situation is a core mental status finding and helps establish a
baseline for neurological reasoning.
2. Which three response categories are scored in the Glasgow Coma Scale?
A. Eye opening, verbal response, and motor response
B. Pupillary size, gait, and reflexes
NAS2 Challenge Exam 2026/2027
,C. Cranial nerve function, strength, and sensation
D. Memory, judgment, and affect
Answer: A
Rationale: The Glasgow Coma Scale quantifies eye, verbal, and motor responses. It is used to trend level of
consciousness after injury or neurological decline.
3. Which technique is most appropriate for screening cranial nerve II visual acuity in a clinic
setting?
A. Asking the patient to shrug against resistance
B. Using a Snellen or near-vision chart
C. Testing gag reflex with a tongue blade
D. Palpating the temporal artery
Answer: B
Rationale: Cranial nerve II carries visual sensory input. Snellen or near-vision testing is a standard method for
assessing visual acuity.
4. When a light is directed into the right eye, both pupils constrict. Which cranial nerve provides
the efferent limb for pupillary constriction?
A. Optic nerve, CN II
B. Trochlear nerve, CN IV
C. Oculomotor nerve, CN III
D. Trigeminal nerve, CN V
Answer: C
Rationale: The oculomotor nerve carries parasympathetic fibers responsible for pupillary constriction. CN II is
the afferent limb for light perception.
5. A patient is asked to follow the nurse's finger through six cardinal fields of gaze. What is the
nurse primarily assessing?
A. Extraocular muscle function mediated by CN III, IV, and VI
B. Facial sensation mediated by CN V
C. Hearing acuity mediated by CN VIII
D. Tongue strength mediated by CN XII
Answer: A
Rationale: The six cardinal fields assess coordinated eye movement involving the oculomotor, trochlear, and
abducens nerves.
6. Which finding specifically evaluates the motor branch of the trigeminal nerve?
A. Patient clenches teeth while the nurse palpates the masseter muscles
B. Patient identifies a familiar smell with each nostril
C. Patient reads small print from a card
D. Patient repeats whispered numbers
Answer: A
Rationale: CN V motor function innervates muscles of mastication. Palpating the masseter and temporal muscles
during clenching screens this function.
7. Which instruction best screens motor function of the facial nerve?
A. Smile, frown, raise eyebrows, and puff out cheeks
B. Turn the head against resistance
C. Swallow water while the thyroid is palpated
D. Identify vibration on the great toe
Answer: A
Rationale: CN VII controls muscles of facial expression. Symmetry during smiling, frowning, eyebrow elevation,
and cheek puffing is assessed.
8. Which bedside test compares air conduction to bone conduction?
A. Romberg test
B. Rinne test
C. Weber test
D. Brudzinski test
NAS2 Challenge Exam 2026/2027
, Answer: B
Rationale: The Rinne test compares air and bone conduction using a tuning fork. It helps screen conductive
versus sensorineural patterns.
9. A nurse asks the patient to say “ah” while observing symmetric palate elevation. Which cranial
nerves are primarily assessed?
A. CN I and II
B. CN III and IV
C. CN IX and X
D. CN XI and XII
Answer: C
Rationale: Glossopharyngeal and vagus nerves contribute to palate elevation, swallowing, and phonation.
Asymmetric movement may indicate neurological dysfunction.
10. Which action tests the spinal accessory nerve?
A. Shoulder shrug against resistance
B. Tongue protrusion at midline
C. Corneal light reflex
D. Identification of sharp versus dull touch
Answer: A
Rationale: CN XI innervates the trapezius and sternocleidomastoid muscles. Shoulder shrug and head turn
against resistance screen its motor function.
11. The nurse asks the patient to protrude the tongue and move it side to side. Which nerve is being
assessed?
A. Facial nerve, CN VII
B. Hypoglossal nerve, CN XII
C. Vestibulocochlear nerve, CN VIII
D. Accessory nerve, CN XI
Answer: B
Rationale: CN XII controls tongue movement. Deviation, weakness, or fasciculations can suggest hypoglossal
impairment.
12. A patient repeatedly overshoots the nurse's finger during finger-to-nose testing. Which
abnormal finding is present?
A. Dysmetria
B. Aphasia
C. Nuchal rigidity
D. Anosmia
Answer: A
Rationale: Dysmetria is impaired judgment of distance or range of movement. It is commonly associated with
cerebellar dysfunction.
13. Which abnormality is demonstrated by inability to perform rapid alternating hand movements
smoothly?
A. Dysdiadochokinesia
B. Miosis
C. Presbyopia
D. Exophthalmos
Answer: A
Rationale: Dysdiadochokinesia is impaired rapid alternating movement and suggests cerebellar involvement.
14. A patient can stand steadily with eyes open but sways markedly when the eyes are closed. What
does this positive Romberg test suggest?
A. Impaired proprioception or vestibular function
B. Normal cerebellar function without concern
C. Acute thyroid enlargement
D. Conductive hearing loss only
Answer: A
NAS2 Challenge Exam 2026/2027
